The increase in absolute risk of DKA, even in closely supervised patients participating in clinical trials, raises a serious concern that DKA will be even more common if SGLT inhibitors are used in routine clinical practice by practitioners who do not have the expertise and resources of the clinical trialists to implement the complex recommendations necessary to mitigate risk for DKA (Diabetes Care)
Diabetes News
Tag: Type 1 Diabetes
Adjunct Therapy in Type 1 Diabetes: A Survey to Uncover Unmet Needs and Patient Preferences Beyond HbA1c Measures
This survey highlights the importance of measures beyond HbA1c, such as treatment simplification and TIR, and patient preference for adjunct therapies that help address unmet needs in type 1 diabetes treatment (Diabetes Technology and Therapeutics)
Factors Affecting Cardiovascular Risk in Children, Adolescents, and Young Adults with Type 1 Diabetes
The frequency of cardiovascular risk factors is high in youth with T1D and associated with diabetes duration, obesity, and metabolic control (Journal of Diabetes Research)
Depression in type 1 diabetes and risk of dementia
For people with T1D, depression significantly increases dementia risk. Given the pervasiveness of depression in T1D, this has major implications for successful aging in this population recently living to old age (Aging & Mental Health)
Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes
Type 1 diabetes diagnosed over 30 years of age, defined by severe insulin deficiency, has similar clinical and biological characteristics to that occurring at younger ages, but is frequently not identified. Clinicians should be aware that patients progressing to insulin within 3 years of diagnosis have a high likelihood of type 1 diabetes, regardless of initial diagnosis (Diabetologia)
Impaired awareness of hypoglycemia: a new risk factor for adverse pregnancy outcomes in type 1 diabetes
Impaired awareness of hypoglycemia: a new risk factor for adverse pregnancy outcomes in type 1 diabetes (Diabetes Research and Clinical Practice)
Testing for type 1 diabetes autoantibodies in gestational diabetes mellitus (GDM): is it clinically useful?
From several epidemiological studies it appears that diabetes-related autoimmunity is not a main factor in the aetiology of GDM, accounting for less than 10% of all cases (BMC Endocrine Disorders)
Low versus high carbohydrate diet in type 1 diabetes: A 12‐week randomized open‐label crossover study
Compared with an intake of 250 g of carbohydrate per day, restriction of carbohydrate intake to 100 g per day in adults with type 1 diabetes reduced time spent in hypoglycaemia, glycaemic variability and weight with no effect on cardiovascular risk factors (Diabetes, Obesity and Metabolism)
Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in type 1 diabetes: meta-analysis of randomised controlled trials
In type 1 diabetes, sotagliflozin improves glycaemic and non-glycaemic outcomes and reduces hypoglycaemia rate and severe hypoglycaemia. The risk of diabetic ketoacidosis could be minimised by appropriate patient selection and down-titration of the basal insulin dose (BMJ)
Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes
Clinicians should be aware that patients progressing to insulin within 3 years of diagnosis have a high likelihood of type 1 diabetes, regardless of initial diagnosis (Diabetologia)
Iron deficiency in long standing type 1 diabetes mellitus and its association with depression and impaired quality of life
Type 1 diabetes patients in the current study were frequently depressive and reported an impaired QoL that associated with iron insufficiency. If confirmed a better awareness is needed for depression and ID in long standing disease (Diabetes Research and Clinical Practice)
A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes
This pathway is endorsed by UK‐wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes (Diabetic Medicine)
Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study
Despite reductions in the rate of increase in some high-risk countries, the pooled estimate across centres continues to show a 3.4% increase per annum in incidence rate, suggesting a doubling in incidence rate within approximately 20 years in Europe (Diabetologia)
The relationships between markers of tubular injury and intrarenal haemodynamic function in adults with and without type 1 diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes
Elevated NGAL relates to intrarenal haemodynamic dysfunction in T1D, whereas elevated NGAL and B2M relate to intrarenal haemodynamic dysfunction in adults without T1D. These data may define a diabetes‐specific interplay between tubular injury and intrarenal haemodynamic dysfunction (Diabetes, Obesity and Metabolism)
Association of Insulin Dose, Cardiometabolic Risk Factors, and Cardiovascular Disease in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study
During DCCT/EDIC, higher insulin doses were associated with adverse trends in several cardiometabolic risk factors, even after multivariable adjustment, but not with incident CVD outcomes (Diabetes Care)
Text‐message responsiveness to blood glucose monitoring reminders is associated with HbA1c benefit in teenagers with Type 1 diabetes
Teenagers with Type 1 diabetes who responded to text reminders on ≥50% of days over 18 months experienced clinically significant glycaemic benefit. There remains a need to tailor interventions to maintain teenager engagement and optimize improvements (Diabetic Medicine)
Understanding adolescent and parent acceptability and feasibility experience in a large Type 1 diabetes mellitus behavioural trial
Acceptability and feasibility of behavioural interventions with adolescents with chronic illness have multifactorial dimensions. While empowering adolescent self‐management, parental support is also an under‐appreciated aspect to consider. Potential revisions were identified for subsequent behavioural trialsAcceptability and feasibility of behavioural interventions with adolescents with chronic illness have multifactorial dimensions. While empowering adolescent self‐management, parental support is also an under‐appreciated aspect to consider. Potential revisions were identified for subsequent behavioural trialshttps://onlinelibrary.wiley.com/doi/abs/10.1111/dme.13913
The prevalence of retinopathy in patients with type 1 diabetes treated with education-based intensified insulin therapy and its association with parameters of glucose control
In type 1 diabetes EBIIT is associated with good diabetes control and a low prevalence of DR. The cumulative glucose exposure over time given as HbA1c years is the best predictor for development of DR (Diabetes Research and Clinical Practice)
Is there an optimal strategy for real‐time continuous glucose monitoring in pediatrics? A 12‐month French multi‐center, prospective, controlled randomized trial (Start‐In!)
None of the three long‐term RT‐CGM strategies evaluated in pediatric type 1 diabetes was superior to the others in terms of HbA1c levels. CGM‐use for three months decreased rates of severe hypoglycemia. Our results confirm the feasibility of long‐term RT‐CGM‐use and the need to improve educational support for patients and caregivers (Pediatric Diabetes)
Predicting Progression to Type 1 Diabetes from Ages 3 to 6 in Islet Autoantibody Positive TEDDY Children
This study highlights the application of precision medicine techniques to predict progression to diabetes over a 3‐year window in TEDDY subjects. This multifaceted model provides preliminary improvement in prediction over simpler prediction tools. Additional tools are needed to maximize the predictive value of these approaches (Pediatric Diabetes)
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